Acne Treatment for Hormonal Acne
Acne, the most common skin condition identified by dermatologists, plagues up to 50 million people each year, according to the American Academy of Dermatology, known as the AAD. Although most people consider acne a teenage problem, anyone can get acne in their 20s, 30s and 40s. In fact, many women suffer from hormonal acne linked to their menstrual cycles. For these women, oral contraceptives may be an effective acne treatment choice.
Acne has several interrelated causes, according to MayoClinic.com. First, hormonal changes or surges cause the skin's sebaceous glands, which make the oil that lubricates the skin, to produce too much oil. The hormones that stimulate the sebaceous glands are called androgens, which are male-type hormones. Once the sebaceous glands are making too much oil, that oil can combine with dead cells to irritate and plug pores, causing pimples to erupt. Oily skin also provides an ideal home for bacteria, leading to infection in existing acne lesions.
Acne often occurs in women with too much circulating androgen hormone, or whose sebaceous glands are particularly sensitive to androgen. It also occurs in many women just before or during their menstrual cycles, when hormone shifts are common. Oral contraceptives, which contain the female hormone estrogen, work to smooth out hormonal surges, especially the surges of androgen hormones that overstimulate the sebaceous glands. They also regulate the menstrual cycle, lessening or eliminating the hormone shifts that cause pimples at that time.
The U.S. Food and Drug Administration has approved three brand-name oral contraceptives specifically for use in treating acne: Estrostep, Ortho Tri-Cyclen and Yaz. However, other brands and generic birth control pills also will fight acne, and many dermatologists prescribe oral contraceptives that haven't been specifically FDA-approved for acne treatment.
A variety of medical studies have shown oral contraceptives are effective in acne treatment. In one study, led by Dr. Gerd Plewig and published in 2009 in the journal "Contraception," researchers looked at 377 women with moderate acne who received either an oral contraceptive or a placebo. Nearly three-fourths of the women taking the oral contraceptive reported a satisfactory improvement in their acne, and 40 percent reported excellent improvement or even complete resolution of their pimples.
Oral contraceptives take up to six months to show effectiveness in acne treatment, and Mayo Clinic dermatologist Dr. Lawrence E. Gibson, M.D., warns that skin can appear worse before it starts to improve. Dermatologists often prescribe topical agents such as Retin-A or benzoyl peroxide to fight acne along with oral contraceptives. In addition, physicians will not prescribe oral contraceptives for everyone. Women who are older than age 35, or who have a medical history that includes migraines, high blood pressure or cancer, may not be eligible for a prescription.
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